The Evolving Diabetes Burden in the United States

Engelgau, Michael M.; Geiss, Linda S.; Saaddine, Jinan B.; Boyle, James P.; Benjamin, Stephanie M.; Gregg, Edward W.; Tierney, Edward F.; Rios-Burrows, Nilka; Mokdad, Ali H.; Ford, Earl S.; Imperatore, Giuseppina; Narayan, K.M. Venkat

doi:10.7326/0003-4819-140-11-200406010-00035

Cited by 590 publications

(381 citation statements)

References 34 publications

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“…Type 2 diabetes; serious mental illness; cardiovascular risk; metabolic syndrome In 2002, Type 2 diabetes affected approximately 6.3% of the US population at an estimated cost of $132 billion (American Diabetes Association, 2003;Engelgau et al, 2004). Type 2 diabetes is associated with a twofold to fourfold increased risk for major cardiovascular events and is considered a coronary heart disease risk equivalent that confers a level of risk equal to that in patients with pre-existing cardiovascular disease (CVD; Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001).…”

Section: Introductionmentioning

confidence: 99%

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Kreyenbuhl¹,

Dickerson²,

Medoff³

et al. 2006

Journal of Nervous &Amp; Mental Disease

103

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Cardiovascular disease is the leading cause of death in Type 2 diabetes, which commonly occurs in patients with serious mental illnesses (SMIs). We determined the extent to which patients with diabetes and SMI, relative to diabetes patients without SMI, met American Diabetes Association goals for cholesterol and blood pressure, met criteria for the metabolic syndrome, and were prescribed medications known to reduce cardiovascular events. We found that less than half of diabetes patients, both with and without SMI, met recommended goals for cholesterol levels; even fewer had adequate blood pressure control. In addition, a substantial proportion of all diabetes patients met metabolic syndrome criteria. However, diabetes patients with SMI were less likely to be prescribed cholesterol-lowering statin medications, angiotensin-converting enzyme inhibitors, and angiotensin receptor blocking agents than diabetes patients without SMI. Patients with both diabetes and SMI are treated less aggressively for high cardiovascular risk than diabetes patients without mental disorders. KeywordsType 2 diabetes; serious mental illness; cardiovascular risk; metabolic syndrome In 2002, Type 2 diabetes affected approximately 6.3% of the US population at an estimated cost of $132 billion (American Diabetes Association, 2003;Engelgau et al., 2004). Type 2 diabetes is associated with a twofold to fourfold increased risk for major cardiovascular events and is considered a coronary heart disease risk equivalent that confers a level of risk equal to that in patients with pre-existing cardiovascular disease (CVD; Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001). Cardiovascular and cerebrovascular complications of Type 2 diabetes account for 60% to 75% of deaths from this disease (Stamler et al., 1993). Metabolic abnormalities characteristic of Type 2 diabetes including insulin resistance and dyslipidemias contribute in part to the increased CVD risk, with emerging evidence suggesting that persistent hyperglycemia may also play a role (Nathan et al., 2003;Selvin et al., 2004 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript frequent co-occurrence of hypertension, overweight and obesity, smoking, and reduced physical activity in patients with diabetes confers an additive CVD risk that exceeds the sum of their risks individually (Wilson et al., 1998). There is also mounting evidence that the cluster of risk factors that comprise the metabolic syndrome increases the risk for cardiovascular mortality , and by definition, would be expected to occur disproportionately in people with Type 2 diabetes.Persons with serious mental illnesses such as schizophrenia have an increased risk for Type 2 diabetes (Dixon et al., 2000) and other co-occurring medical conditions. Life expectancy in people with schizophrenia is 20% shorter than that of the general population (Newman and Bland, 1991), with the excess mortality largely attributed to higher rates of CVD (Brown et al., 2000;Os...

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Section: Introductionmentioning

confidence: 99%

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Kreyenbuhl¹,

Dickerson²,

Medoff³

et al. 2006

Journal of Nervous &Amp; Mental Disease

103

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“…Tight regulation of glucose homeostasis is fundamental to all higher life forms, and dysregulated glucose metabolism is a significant medical problem (1,2). The liver has a major role in determining glucose levels through its control of both hepatic glucose uptake and glucose release.…”

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confidence: 99%

Thioredoxin-interacting Protein (Txnip) Is a Critical Regulator of Hepatic Glucose Production

Chutkow¹,

Patwari²,

Yoshioka

et al. 2008

Journal of Biological Chemistry

172

158

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Thioredoxin-interacting protein (Txnip) has been recently described as a possible link between cellular redox state and metabolism; Txnip binds thioredoxin and inhibits its disulfide reductase activity in vitro, while a naturally occurring strain of Txnip-deficient mice has hyperlipidemia, hypoglycemia, and ketosis exacerbated by fasting. We generated Txnip-null mice to investigate the role of Txnip in glucose homeostasis. Txnip-null mice were hypoglycemic, hypoinsulinemic, and had blunted glucose production following a glucagon challenge, consistent with a central liver glucose-handling defect. Glucose release from isolated Txnip-null hepatocytes was 2-fold lower than wild-type hepatocytes, whereas ␤-hydroxybutyrate release was increased 2-fold, supporting an intrinsic defect in hepatocyte glucose metabolism. While hepatocyte-specific gene deletion of Txnip did not alter glucose clearance compared with littermate controls, Txnip expression in the liver was required for maintaining normal fasting glycemia and glucose production. In addition, hepatic overexpression of a Txnip transgene in wildtype mice resulted in elevated serum glucose levels and decreased ketone levels. Liver homogenates from Txnip-null mice had no significant differences in the glutathione oxidation state or in the amount of available thioredoxin. However, overexpression of wild-type Txnip in Txnip-null hepatocytes rescued cellular glucose production, whereas overexpression of a C247S mutant Txnip, which does not bind thioredoxin, had no effect. These data demonstrate that Txnip is required for normal glucose homeostasis in the liver. While available thioredoxin is not changed in Txnip-null mice, the effects of Txnip on glucose homeostasis are abolished by a single cysteine mutation that inhibits binding to thioredoxin.Tight regulation of glucose homeostasis is fundamental to all higher life forms, and dysregulated glucose metabolism is a significant medical problem (1, 2). The liver has a major role in determining glucose levels through its control of both hepatic glucose uptake and glucose release. During fasting states the liver is particularly important, as it is the primary organ for maintaining blood glucose levels by up-regulating gluconeogenesis and glycogenolysis to increase glucose release (3, 4). These processes are coordinated by hormonal control, primarily through the reciprocal actions of glucagon and insulin, as well as through glucocorticoid and adipokine cues (5, 6). Downstream effectors of hormonal inputs include transcription factors and coactivators that act as master regulators of metabolic transcriptional programs, such as PGC1␣, 3 CREB, TORC2, and Foxo1 (7-10). Other mechanisms governing hepatic carbohydrate metabolism include changes in substrate availability (11), changes in mitochondrial respiration (12, 13), and altered cellular redox state (14, 15).The thiol-disulfide redox state of the cell is emerging as an important regulator of diverse processes, including metabolism (16 -19). A key regulator is thioredoxin, a u...

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“…It is a common disorder known to everybody nowadays, with a prevalence that rises markedly with increasing degrees of obesity 1 . The prevalence of type 2 diabetes is rising in the past decade 2 . and is mostly associated with obesity3.…”

Section: Introductionmentioning

confidence: 99%

Relation between Type 2 Diabetes and obesity: A review

Kumar¹

2013

Int Jour of Biomed Res

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The Evolving Diabetes Burden in the United States

Cited by 590 publications

References 34 publications

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Thioredoxin-interacting Protein (Txnip) Is a Critical Regulator of Hepatic Glucose Production

Relation between Type 2 Diabetes and obesity: A review

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